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All Journal The International Journal of Medical Science and Health Research The Indonesian Journal of General Medicine
Anggar Jito
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Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Coexistence of Ovarian Endometrioma, Leiomyoma, and Genital Tuberculosis Mimicking Malignancy: A Case Report Kirana Paramitha Santosa; Anggar Jito
The International Journal of Medical Science and Health Research Vol. 27 No. 1 (2026): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/hmzc6352

Abstract

Introduction: Genital tuberculosis (TB) can present with nonspecific symptoms and clinical findings that resemble gynecologic malignancy, particularly when accompanied by elevated tumor markers, large pelvic masses, and ascites.1 Case Report: A 34-year-old female presented with progressive lower abdominal pain for five months, especially during menstruation. Additional symptoms included weight loss, abdominal distension, difficulty with defecation and urination. Abdominal MSCT demonstrated the presence of ascites and a large adnexal mass compressing the rectum, suggestive of malignancy. Laboratory testing showed an elevated CA-125 level of 372.70 U/mL. Initially, ovarian malignancy was the primary differential diagnosis. After thorough consideration, a bilateral oophorectomy and hysterectomy were performed, despite the patient not yet having borne children. Histopathological examination of the surgical specimens revealed a leiomyoma, ovarian endometrioma, and chronic granulomatous inflammation consistent with TB infection was found in both ovaries and endometrium. Discussion: This case underlines the importance of considering genital TB in the differential diagnosis of pelvic masses with elevated CA-125, especially in TB-endemic regions.2 This is crucial because both diseases can coexist in the same individual. When malignancy is initially suspected, it is important to conduct a thorough investigation to rule out or confirm TB, as the treatment and management strategies differ significantly, potentially avoiding unnecessary aggressive intervention.3 Conclusion: This study emphasizes the importance of including GTB in the differential diagnosis of pelvic masses associated with elevated tumor markers, particularly in TB-endemic regions. This consideration is essential because benign pelvic masses and GTB may coexist in the same patient. Given the wide variability in clinical presentation and the limited accuracy of current diagnostic modalities, it may be misdiagnosed as a gynecologic malignancy which has a significantly different treatment strategies. Keywords: leiomyoma, endometrioma, genital tuberculosis
Double Mycobacterial Infection in Septic Patient: A Rare Case of Pulmonary Tuberculosis and Leprosy Coinfection Kirana Paramitha Santosa; Anggar Jito
The Indonesian Journal of General Medicine Vol. 25 No. 1 (2026): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/ktbbxd98

Abstract

Introduction: Co-infection of Tuberculosis (TB) and Leprosy is a rare occurrence, even in endemic areas.1 This co-infection has higher risks of drug resistance, complications, and mortality.2,3 Case Report: A 38-year-old male patient, who had been taking long-term steroids, presented in severe condition, showing signs of sepsis and ARDS. Multilobar infiltrates were found in both lungs, MTB/RIF was positive and sensitive to Rifampicin, BTA was found in slit skin smear test, liver enzyme levels were elevated, D-dimer level was increased (6 mg/L), low PaO2/FiO2 ratio (44.25 mmHg), along with an increased AaDO2 (508.4 mmHg). Despite receiving antimicrobial and anti-tuberculosis therapy, the patient's condition continued to deteriorate, resulting in septic shock and death. Discussion: The rarity of these cases in the modern literature is likely due to Bacillus Calmette-Guérin (BCG) vaccination in endemic areas, which provides at least partial protection against both diseases. Dual infection is associated with higher morbidity (5.5%) and mortality (37.2%).2 Appropriate diagnostic, screening, and therapeutic regimens are needed in clinical practice to prevent the risk of drug resistance and complications. This study aimed to present a complicated case of pulmonary TB and multibacillary leprosy co-infection in a septic patient.
Co-Authors Kirana Paramitha Santosa